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Fatigue

Fatigue

Julie
At first, when Sam wasn’t sleeping much, we were just all so exhausted. I worried about how the fatigue would affect Sam’s healing. He was just so agitated, and he… he didn’t understand what was happening to him. The fatigue was literally etched onto his face.

Tracy
That’s a good point. Yeah fatigue is a common complaint among people with TBI. Just like the body, the brain needs a huge amount of energy for healing after a traumatic injury. And, as we’ve just learned, sleep patterns can be totally disrupted, especially in the first weeks and months after the injury.

For most people, fatigue gradually lessens over time while stamina and endurance improve. And for others, their endurance is just not what it used to be so… so they have to pace themselves more than they did before the injury.

Megan
So when the time comes, will there be anything I can do to help Clay with that?

Tracy
Oh well, sure. You can help him pace himself. You can encourage him to conserve energy for those important tasks of the day, like physical therapy. Setting up a daily schedule can be a huge help. 

Now since regular exercise will increase stamina, his physical therapist will work with you to develop a safe exercise program, based on his abilities of course.

Megan
Yeah it’s just hard to imagine him exercising right now. I just want him to wake up.

Tracy
I know... it just takes time.
 
Julie
Well, Sam had a lot of problems with fatigue. Even before he would say anything, we could tell that he was tired.

Carl
Yeah, he would be so irritable and angry. He’d start to yell, and sometimes his face would even start to droop. His confusion would be so much worse when he was fatigued.

Tracy
How did you handle that?

Carl
Well it helped to make a list of Sam’s signs of fatigue, and when they happened. That way, we could work his schedule around it, like setting important appointments for times when he was the most awake.

Julie
And based on that list, we noticed there were particular times of day when he was most fatigued, so we blocked those times out for rest.

Michelle
That’s a great idea. Now that Tom’s awake more, and he showing more signs of fatigue, I’m gonna start keeping a list.

Seizures

Seizures happen when the electrical system in the brain misfires.

Seizures can be frightening to watch.

Two kinds of seizures may occur following a severe TBI:

  • Early seizures—also called “generalized seizures” or “Grand Mal seizures”—typically happen during the first week after an injury.
  • Later seizures usually occur after the first week of injury in individuals who have never had a seizure before. People who have late-onset seizures are more likely to have a penetrating injury or one that causes a large amount of bleeding in the brain.

Seizures can be temporary or chronic. Late-onset seizures carry a greater risk of future seizures than do early seizures.

A neurologist is the member of the health care team who usually diagnoses seizures. He or she will treat seizures with medications.

What you may see:

  • Generalized shaking or jerking of the arms and legs 
  • Loss of consciousness 
  • Altered attention, emotion, sensation, or movement 
  • Complaints of strange odors or sensations

Late-onset seizures can also cause changes in smell, behavior, or personality. Sometimes, people mistake a seizure as a psychiatric disorder.

Ask your doctor early on about how to recognize a seizure and what to do if one occurs.

How you can help:

  • For a first seizure, call your doctor as soon as possible.
  • If not a first seizure, alert the doctor. Make an appointment to have anti-seizure medication and blood levels checked.
  • Talk to the doctor before adding or stopping medications or herbal treatments. These can change the blood level of the anti-seizure medication and make it ineffective.
  • During a seizure:
    •  Keep calm.
    •  Don’t hold your family member down or try to stop his or her movements.
    •  Loosen ties or anything around the neck that makes breathing hard to do.
    •  Clear anything hard or sharp from the surrounding area.
    •  Put something flat and soft under the head.
    •  Turn the person gently onto one side. This helps keep the airway clear.
    •  Do not try to force the mouth open. 
    •  Stay with the person until the seizure ends.
CALL 911 if your service member/veteran experiences:
  • Difficulty breathing during or after a seizure 
  • Seizure lasting more than five minutes
  • Second seizure that happens immediately after the first seizure
  • Difficulty waking up from the seizure or a second seizure without waking up in between

Some things are triggers for seizures. These include: 

  • Stress 
  • Overuse of alcohol and/or other drugs 
  • Being overworked and/or tired

Help your service member/veteran to avoid these triggers.

Driving laws for people with seizures vary from state to state. Check with your Department of Motor Vehicles to find out what the rules are for your family member if he or she has a seizure disorder.

Related Information:
Fatigue/Loss of Stamina
Other Physical Effects
Glossary
Frequently Asked Questions
"He really won’t tell me the whole story because I think he doesn’t want to scare me. But, he brought me a piece of metal back home that was embedded in the wall right behind him. He said it missed his head by a few inches. He said that he thanks God every day that he’s still alive, and that’s why he brought the piece of metal home, to show me that that’s how close he had come to dying." -  Lynn C-S.

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